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Effects of food on physical and sleep complaints in children with ADHD: a randomised controlled pilot study.

Pelsser LM, Frankena K, Buitelaar JK, Rommelse NN - Eur. J. Pediatr. (2010)

Bottom Line: Specific complaints that were significantly reduced were in three domains: headaches or bellyaches, unusual thirst or unusual perspiration, and sleep complaints.A positive correlation existed between the reduction of physical and behavioural symptoms (p < 0.01).The reduction did not differ between children with or without an atopic constitution (p = 0.7).

View Article: PubMed Central - PubMed

Affiliation: ADHD Research Centre, Liviuslaan 49, 5624 JE Eindhoven, The Netherlands. lmjpelsser@adhdresearchcentre.nl

ABSTRACT
Attention deficit/hyperactivity disorder (ADHD), a common behavioural disorder in children, may be associated with comorbid physical and sleep complaints. Dietary intervention studies have shown convincing evidence of efficacy in reducing ADHD symptoms in children. In this pilot study, we investigated the effects of an elimination diet on physical and sleep complaints in children with ADHD. A group of 27 children (3.8-8.5 years old), who all met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for ADHD, were assigned randomly to either a diet group (15/27) or a control group (12/27). The diet group followed a 5-week elimination diet; the control group adhered to their normal diet. Parents of both groups had to keep an extended diary and had to monitor the behaviour and the physical and sleep complaints of their child conscientiously. The primary endpoint was the clinical response, i.e. a decrease of physical and sleep complaints, at the end of the trial, based on parent ratings on a Physical Complaints Questionnaire. The number of physical and sleep complaints was significantly decreased in the diet group compared to the control group (p < 0.001), with a reduction in the diet group of 77% (p < 0.001, effect size = 2.0) and in the control group of 17% (p = 0.08, effect size = 0.2). Specific complaints that were significantly reduced were in three domains: headaches or bellyaches, unusual thirst or unusual perspiration, and sleep complaints. The reduction of complaints seemed to occur independently of the behavioural changes (p = 0.1). However, the power of this comparison was low. A positive correlation existed between the reduction of physical and behavioural symptoms (p < 0.01). The reduction did not differ between children with or without an atopic constitution (p = 0.7). An elimination diet may be an effective instrument to reduce physical complaints in children with ADHD, but more research is needed to determine the effects of food on (functional) somatic symptoms in children with and without ADHD. This trial was registered as an International Standard Randomised Controlled Trial, ISRCTN47247160.

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Physical and sleep complaints in the diet group and the control group at start and at endpoint. Pain: headaches, abdominal pains or growing pains. Thirst: unusual thirst or unusual perspiration. Skin: eczema. Asthma: asthma or persisting cold (rhinitis). Blotch: blotches in the face, red ears, red-edged mouth or bags under the eyes. Tired: tiredness. Bowel: diarrhoea, constipation or flatulence. Sleep: sleeping in or sleeping on
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Fig2: Physical and sleep complaints in the diet group and the control group at start and at endpoint. Pain: headaches, abdominal pains or growing pains. Thirst: unusual thirst or unusual perspiration. Skin: eczema. Asthma: asthma or persisting cold (rhinitis). Blotch: blotches in the face, red ears, red-edged mouth or bags under the eyes. Tired: tiredness. Bowel: diarrhoea, constipation or flatulence. Sleep: sleeping in or sleeping on

Mentions: The results of the intervention on physical and sleep complaints in both groups are shown in Table 2 and Fig. 2. The total number of complaints in the diet group was 44 (average, 3.4 per child) at the start of the trial and ten complaints (average, 0.8) at the end of the trial, a reduction of 77% (p < 0.001), with a standardised effect size (Cohen's d) of 2.0 (Table 3). In the control group, 36 complaints (average, 3.3) were reported at the start of the trial and 30 (average, 2.7) at the end of the trial, a reduction of 17% (p = 0.08), with an effect size of 0.2.Table 2


Effects of food on physical and sleep complaints in children with ADHD: a randomised controlled pilot study.

Pelsser LM, Frankena K, Buitelaar JK, Rommelse NN - Eur. J. Pediatr. (2010)

Physical and sleep complaints in the diet group and the control group at start and at endpoint. Pain: headaches, abdominal pains or growing pains. Thirst: unusual thirst or unusual perspiration. Skin: eczema. Asthma: asthma or persisting cold (rhinitis). Blotch: blotches in the face, red ears, red-edged mouth or bags under the eyes. Tired: tiredness. Bowel: diarrhoea, constipation or flatulence. Sleep: sleeping in or sleeping on
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2908441&req=5

Fig2: Physical and sleep complaints in the diet group and the control group at start and at endpoint. Pain: headaches, abdominal pains or growing pains. Thirst: unusual thirst or unusual perspiration. Skin: eczema. Asthma: asthma or persisting cold (rhinitis). Blotch: blotches in the face, red ears, red-edged mouth or bags under the eyes. Tired: tiredness. Bowel: diarrhoea, constipation or flatulence. Sleep: sleeping in or sleeping on
Mentions: The results of the intervention on physical and sleep complaints in both groups are shown in Table 2 and Fig. 2. The total number of complaints in the diet group was 44 (average, 3.4 per child) at the start of the trial and ten complaints (average, 0.8) at the end of the trial, a reduction of 77% (p < 0.001), with a standardised effect size (Cohen's d) of 2.0 (Table 3). In the control group, 36 complaints (average, 3.3) were reported at the start of the trial and 30 (average, 2.7) at the end of the trial, a reduction of 17% (p = 0.08), with an effect size of 0.2.Table 2

Bottom Line: Specific complaints that were significantly reduced were in three domains: headaches or bellyaches, unusual thirst or unusual perspiration, and sleep complaints.A positive correlation existed between the reduction of physical and behavioural symptoms (p < 0.01).The reduction did not differ between children with or without an atopic constitution (p = 0.7).

View Article: PubMed Central - PubMed

Affiliation: ADHD Research Centre, Liviuslaan 49, 5624 JE Eindhoven, The Netherlands. lmjpelsser@adhdresearchcentre.nl

ABSTRACT
Attention deficit/hyperactivity disorder (ADHD), a common behavioural disorder in children, may be associated with comorbid physical and sleep complaints. Dietary intervention studies have shown convincing evidence of efficacy in reducing ADHD symptoms in children. In this pilot study, we investigated the effects of an elimination diet on physical and sleep complaints in children with ADHD. A group of 27 children (3.8-8.5 years old), who all met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for ADHD, were assigned randomly to either a diet group (15/27) or a control group (12/27). The diet group followed a 5-week elimination diet; the control group adhered to their normal diet. Parents of both groups had to keep an extended diary and had to monitor the behaviour and the physical and sleep complaints of their child conscientiously. The primary endpoint was the clinical response, i.e. a decrease of physical and sleep complaints, at the end of the trial, based on parent ratings on a Physical Complaints Questionnaire. The number of physical and sleep complaints was significantly decreased in the diet group compared to the control group (p < 0.001), with a reduction in the diet group of 77% (p < 0.001, effect size = 2.0) and in the control group of 17% (p = 0.08, effect size = 0.2). Specific complaints that were significantly reduced were in three domains: headaches or bellyaches, unusual thirst or unusual perspiration, and sleep complaints. The reduction of complaints seemed to occur independently of the behavioural changes (p = 0.1). However, the power of this comparison was low. A positive correlation existed between the reduction of physical and behavioural symptoms (p < 0.01). The reduction did not differ between children with or without an atopic constitution (p = 0.7). An elimination diet may be an effective instrument to reduce physical complaints in children with ADHD, but more research is needed to determine the effects of food on (functional) somatic symptoms in children with and without ADHD. This trial was registered as an International Standard Randomised Controlled Trial, ISRCTN47247160.

Show MeSH
Related in: MedlinePlus